By ELLEN GOLDBAUM

Teresa Quattrin and a TrialNet family in Western New York
discuss the benefits of the study.

More than 1,000 Western New York children who are at risk of
developing Type 1 diabetes are helping scientists at UB and Women
and Children’s Hospital of Buffalo (WCHOB) find ways to
prevent, delay or reverse the disease.

They are participants in TrialNet, an international network of
researchers funded by the National Institutes of Health and
dedicated to finding ways to prevent, delay and reverse the
progression of Type 1 diabetes. The children are at high risk
because they have a close relative, often a sibling, with the
disease.

“Out of the more than 112,000 participants worldwide,
since 2005, we have enrolled 1,425 in our main TrialNet study
‘Pathway to Prevention,’” explains Teresa
Quattrin, UB Distinguished Professor and A. Conger Goodyear
Professor and chair, Department of Pediatrics, School of Medicine
and Biomedical Sciences, and pediatrician-in-chief and chief of the
Division of Diabetes/Endocrinology at WCHOB.

Quattrin is principal investigator on the grant at the UB and
WCHOB center, one of 200 TrialNet screening sites worldwide; it is
affiliated with Columbia University, one of TrialNet’s 18
clinical centers.

The increased incidence of Type 2 diabetes—caused largely
by obesity—has been well-documented.

But rates of Type 1 diabetes, an autoimmune disease in which the
body destroys its ability to make insulin and requires insulin
injections for survival, also are increasing by 3 to 5 percent
annually. The reasons are as yet unknown, but TrialNet is giving
families at risk new options and new hope.

According to Quattrin, previous research in Buffalo and
elsewhere has revealed that it can take years for Type 1 diabetes
to progress to the point where the patient exhibits symptoms, such
as thirst, extreme hunger, frequent urination, weight loss and
blurred vision. A patient may be completely healthy for years,
but may exhibit biomarkers in the blood and genetic characteristics
that reveal that within five or 10 years, it is likely they will
experience symptoms and develop Type 1 diabetes.

“In individuals who are going to become Type 1 diabetics,
their ability to make insulin declines very slowly over a period of
years, up to the point where there is only 10-15 percent insulin
left and that’s when symptoms appear,” Quattrin says.
“TrialNet focuses on that window that precedes the onset of
diabetes.”

TrialNet builds upon earlier studies that identified autoimmune
biomarkers, known as autoantibodies, and other factors that
describe exactly how an individual who is at risk evolves over time
into a Type 1 diabetic.

“These sophisticated studies were able to determine the
factors, such as an individual’s genetic makeup, as well as
autoimmune conditions, that influence why someone develops Type 1
diabetes faster than someone else,” Quattrin says.
“These studies have provided a kind of road map that now
allow us to predict with extreme precision when and if an
individual will come down with Type 1 diabetes.”

Sisters, brothers, parents under age 45 and children of Type 1
diabetics are eligible to enroll. More distant relatives also may
be able to enroll. Through blood tests and glucose tolerance tests,
TrialNet offers a way for families to know who is at high risk for
developing diabetes. Some children at risk with specific biomarkers
can be enrolled in a study in which they take oral insulin that may
be able to delay the onset of the disease.

That’s what the Lockwood family of Colden, N.Y., hopes for
9-year-old Jillian Lockwood. She got involved in TrialNet when her
brother, 12-year-old Dawson, was diagnosed with Type 1 diabetes at
WCHOB in 2009. Not long after the diagnosis, Jillian and her older
brother, Connor, were tested for biomarkers as part of TrialNet;
Jillian tested positive.

Jillian is taking either oral insulin or a placebo; if she is
taking the insulin, it is possible, Quattrin explains, that it will
help her body preserve more insulin, staving off diabetes for
years.

“Preserving insulin for more years, and therefore keeping
blood sugars at a normal level, will greatly reduce the chance of
complications that arise from poorly controlled blood
sugars,” says Quattrin.

Children, like Connor Lockwood, who test negative, are screened
annually so that if they do develop biomarkers that show they
eventually will develop diabetes, they can start insulin early and
not experience the severe symptoms and hospitalization that newly
diagnosed diabetics undergo.

“With Connor in TrialNet, the benefit is early
diagnosis,” says Mrs. Lockwood. “We won’t have to
worry, is he becoming diabetic? We will know if he is developing
the autoantibodies. And if the oral insulin means that could help
Jillian not become diabetic until she’s 20 or 25, then
we’ll take it,” she says. “And if it finds a cure
and helps somebody else, then it’s tenfold the reason for
doing this.”

Family members of Type 1 diabetics—either siblings,
parents, children, cousins, grandchildren, nieces or
nephews—who are interested in participating in TrialNet in
Buffalo should contact Amanda House, project coordinator for
TrialNet, at WCHOB at 878-7268.More than 1,000 Western New York
children who are at risk of developing Type 1 diabetes are helping
scientists at UB and Women and Children’s Hospital of Buffalo
(WCHOB) find ways to prevent, delay or reverse the disease.

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